Teaching behaviors in the attending-resident interaction

Area of Science:

• Medical Education
• Clinical Teaching
• Ambulatory Care

Background:

• Effective teaching strategies are crucial for resident development in ambulatory care settings.
• Direct observation and interactional analysis are key methods for studying clinical teaching.
• Understanding resident-physician interactions informs educational research.

Purpose of the Study:

• To analyze teaching behaviors during resident-attending physician interactions in ambulatory care.
• To identify predominant teaching modes and the focus of these interactions.
• To explore challenges in incorporating teaching into the ambulatory clinical environment.

Main Methods:

• Direct observation of 949 resident-attending physician interactions.
• Utilized interactional analysis technique from educational research.
• Categorized interactions based on defined teaching behaviors.

Main Results:

• Team problem-solving was the predominant teaching mode, focused on current patient issues.
• Hypothetical scenarios occurred in less than 20% of interactions, initiated by attending physicians.
• Questioning and positive reinforcement were used less frequently than anticipated.

Conclusions:

• Clinical teaching in ambulatory settings often centers on immediate patient problems.
• Attending physicians primarily drive advanced teaching discussions.
• Integrating formal teaching goals into ambulatory care presents unique challenges and opportunities.